Provider Demographics
NPI:1235979253
Name:RIZO, CAYLEEN (OTR/L)
Entity type:Individual
Prefix:
First Name:CAYLEEN
Middle Name:
Last Name:RIZO
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:766 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:SHREWSBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:07702-4203
Mailing Address - Country:US
Mailing Address - Phone:855-428-8246
Mailing Address - Fax:855-428-8246
Practice Address - Street 1:115 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:NEW SMYRNA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32168-7068
Practice Address - Country:US
Practice Address - Phone:855-428-8246
Practice Address - Fax:855-428-8246
Is Sole Proprietor?:No
Enumeration Date:2024-05-28
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL25274225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist